Sr. HEDIS Specialist, Provider Quality & Practice Transformation

Molina Healthcare is looking for an experienced Sr. HEDIS Specialist to join our Provider Quality & Practice Transformation team. The Sr. HEDIS Specialist will be responsible for maintaining and enhancing our Health Plan Encounter Data System (HEDIS) process to ensure we are measuring and reporting on quality indicators in accordance with the National Committee for Quality Assurance (NCQA) standards. The ideal candidate will have a comprehensive understanding of quality improvement, clinical and regulatory standards, and experience with data analytics, reporting, and performance improvement initiatives. We are looking for someone with a passion for quality and a commitment to providing top-notch health care services.The successful candidate will possess the following qualifications: Bachelor’s degree in nursing, public health, healthcare administration or related field; 5+ years of experience in healthcare quality improvement/HEDIS and/or provider practice transformation initiatives; Strong knowledge of NCQA regulations and standards; Excellent written and verbal communication skills; and Proficiency in Microsoft Office Suite.

Responsibilities:

1. Maintain and enhance the Health Plan Encounter Data System (HEDIS) process to ensure we are measuring and reporting on quality indicators in accordance with the National Committee for Quality Assurance (NCQA) standards.
2. Monitor and analyze data to identify opportunities for performance improvement initiatives.
3. Develop and implement effective strategies to improve HEDIS performance.
4. Monitor regulatory changes and analyze their impact on the HEDIS process.
5. Create and maintain reports on health plan performance.
6. Train and educate healthcare providers on HEDIS processes and procedures.
7. Develop and implement quality improvement projects.
8. Participate in meetings and committees related to HEDIS and quality improvement initiatives.
9. Prepare and present reports to internal and external stakeholders.
10. Provide technical assistance and guidance to staff and other departments.

According to JobzMall, the average salary range for a Sr. HEDIS Specialist, Provider Quality & Practice Transformation in Long Beach, CA, USA is $39,000 - $89,000.

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.